Nurse leaders slow to adopt evidence-based practices

Efforts to improve patient outcomes and cut costs remain an uphill struggle for many hospitals, and much of the blame may lie with failure to use evidence-based practices, according to research published in Worldviews on Evidence-Based Nursing.

Researchers, led by Bernadette Melnyk, dean of Ohio State University's College of Nursing, surveyed nearly 300 chief nursing executives on how they prioritized evidence-based practice. They found a common theme: Respondents vowed to tackle evidence-based practice after getting patient safety and care quality under control, co-author Lynn Gallagher-Ford toldInfection Control Today. That statement indicates a fundamental misunderstanding of the role such practice plays in hospital operations that likely extends to other hospital leaders as well, she said.

"That's the disconnect--leaders think it is a competing priority when in reality, evidence-based practice is the exact mechanism that needs to be integrated in order to achieve and sustain quality and safety," Gallagher-Ford said.

The Institute of Medicine has set a target for healthcare providers to make 90 percent of their decisions evidence-based by the end of the decade. But Gallagher-Ford told the publication that hospital leaders aren't actually making more progress on the issue.

Melnyk and her team also found a knowledge gap regarding how to measure outcomes, with almost half of respondents telling researchers they were unsure. These statistics are particularly troubling, Melnyk said, because leaders shape a healthcare provider's culture and infrastructure, which means the provider's overall care quality will reflect this lack of knowledge. More than 1 in 3 respondents' organizations did not meet National Database of Nursing Quality Indicators performance metrics, according to the abstract.